PhD Defence: Emma Grundtvig Gram

'Harm in Practice - An Interdisciplinary Study of the Harms of Breast Cancer Screening'

Abstract
Breast cancer screening is widely promoted as a cornerstone of women’s health, grounded in the promise that early detection saves lives. Built on a long history in which cancer came to be understood as a disease progressing in a stepwise manner, and supported by ongoing technological advances in medical imaging, screening has become both a clinical routine and a public health ideal. Yet concerns about harm, such as false-positive results, overdiagnosis, and overtreatment, have accompanied screening since its emergence, even as they may be difficult to see. This thesis examines how the harms of breast cancer screening are not simply measurable outcomes, but are enacted in practice: through clinical routines, institutional arrangements, and interactions between bodies, technologies, and professionals. Drawing on interdisciplinary approaches, the thesis explores how harm is defined, operationalised, and made visible across population-level data, clinical work, and women’s everyday lives. The thesis also raises questions such as: Who has the epistemic right to define harm? What are the ethical and moral implications of communicating harms? And how may biomedical definitions be enriched by experiential knowledge and context-specific forms of understanding?

Assessment committee
(Chairperson) Professor Morten Skovdal, Department of Public Health, University of Copenhagen, Denmark Professor Dorthe Brogård Kristensen, University of Southern Denmark, Denmark Professor Mette Kalager, Department of Health Management and Health Economics, University of Olso, Norway